1
|
Thambinathan V, Lena S, Ramnarine J, Chuang H, Ogbaselassie L, Dagher M, Goulbourne E, Wijayasinghe S, Bawden J, Kennedy L, Wright V. "Access to healthcare is a human right": a constructivist study exploring the impact and potential of a hospital-community partnered COVID-19 community response team for Toronto homeless services and congregate living settings. BMC Health Serv Res 2024; 24:526. [PMID: 38664700 PMCID: PMC11046903 DOI: 10.1186/s12913-023-10140-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 10/12/2023] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Individuals experiencing homelessness face unique physical and mental health challenges, increased morbidity, and premature mortality. COVID -19 creates a significant heightened risk for those living in congregate sheltering spaces. In March 2020, the COVID-19 Community Response Team formed at Women's College Hospital, to support Toronto shelters and congregate living sites to manage and prevent outbreaks of SARS-CoV-2 using a collaborative model of onsite mobile testing and infection prevention. From this, the Women's College COVID-19 vaccine program emerged, where 14 shelters were identified to co-design and support the administration of vaccine clinics within each shelter. This research seeks to evaluate the impact of this partnership model and its future potential in community-centered integrated care through three areas of inquiry: (1) vaccine program evaluation and lessons learned; (2) perceptions on hospital/community partnership; (3) opportunities to advance hospital-community partnerships. METHODS Constructivist grounded theory was used to explore perceptions and experiences of this partnership from the voices of shelter administrators. Semi-structured interviews were conducted with administrators from 10 shelters using maximum variation purposive sampling. A constructivist-interpretive paradigm was used to determine coding and formation of themes: initial, focused, and theoretical. RESULTS Data analysis revealed five main categories, 16 subcategories, and one core category. The core category "access to healthcare is a human right; understand our communities" emphasizes access to healthcare is a consistent barrier for the homeless population. The main categories revealed during a time of confusion, the hospital was seen as credible and trustworthy. However, the primary focus of many shelters lies in housing, and attention is often not placed on health resourcing, solidifying partnerships, accountability, and governance structures therein. Health advocacy, information sharing tables, formalized partnerships and educating health professionals were identified by shelter administrators as avenues to advance intersectoral relationship building. CONCLUSION Hospital-community programs can alleviate some of the ongoing health concerns faced by shelters - during a time of COVID-19 or not. In preparation for future pandemics, access to care and cohesion within the health system requires the continuous engagement in relationship-building between hospitals and communities to support co-creation of innovative models of care, to promote health for all.
Collapse
Affiliation(s)
| | - Suvendrini Lena
- Women's College Hospital, 76 Grenville St., Toronto, ON, M5S 1B2, Canada.
- Neurology and Psychiatry, University of Toronto, 27 King's College Cir, Toronto, ON, M5S 1A1, Canada.
| | - Jordan Ramnarine
- Women's College Hospital, 76 Grenville St., Toronto, ON, M5S 1B2, Canada
| | - Helen Chuang
- Women's College Hospital, 76 Grenville St., Toronto, ON, M5S 1B2, Canada
| | - Luwam Ogbaselassie
- Gattuso Centre for Social Medicine, UHN, 200 Elizabeth St, Toronto, ON, M5G 2C4, Canada
| | - Marc Dagher
- Women's College Hospital, 76 Grenville St., Toronto, ON, M5S 1B2, Canada
- Department of Family and Community Medicine, University of Toronto, 27 King's College Cir, Toronto, ON, M5S 1A1, Canada
| | - Elaine Goulbourne
- Women's College Hospital, 76 Grenville St., Toronto, ON, M5S 1B2, Canada
| | | | - Jessica Bawden
- Women's College Hospital, 76 Grenville St., Toronto, ON, M5S 1B2, Canada
| | - Logan Kennedy
- Women's College Hospital, 76 Grenville St., Toronto, ON, M5S 1B2, Canada
| | - Vanessa Wright
- Women's College Hospital, 76 Grenville St., Toronto, ON, M5S 1B2, Canada
| |
Collapse
|
2
|
Morgan G, Casalino S, Chowdhary S, Frangione E, Fung CYJ, Lapadula E, Arnoldo S, Bearss E, Binnie A, Borgundvaag B, Briollais L, Dagher M, Devine L, Friedman SM, Khan Z, Mighton C, Nirmalanathan K, Richardson D, Stern S, Taher A, Wolday D, Lerner-Ellis J, Taher J. COVID-19 vaccine reactogenicity among participants enrolled in the GENCOV study. Vaccine 2024; 42:2733-2739. [PMID: 38521677 DOI: 10.1016/j.vaccine.2024.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/04/2024] [Accepted: 03/11/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND GENCOV is a prospective, observational cohort study of COVID-19-positive adults. Here, we characterize and compare side effects between COVID-19 vaccines and determine whether reactogenicity is exacerbated by prior SARS-CoV-2 infection. METHODS Participants were recruited across Ontario, Canada. Participant-reported demographic and COVID-19 vaccination data were collected using a questionnaire. Multivariable logistic regression was performed to assess whether vaccine manufacturer, type, and previous SARS-CoV-2 infection are associated with reactogenicity. RESULTS Responses were obtained from n = 554 participants. Tiredness and localized side effects were the most common reactions across vaccine doses. For most participants, side effects occurred and subsided within 1-2 days. Recipients of Moderna mRNA and AstraZeneca vector vaccines reported reactions more frequently compared to recipients of a Pfizer-BioNTech mRNA vaccine. Previous SARS-CoV-2 infection was independently associated with developing side effects. CONCLUSIONS We provide evidence of relatively mild and short-lived reactions reported by participants who have received approved COVID-19 vaccines.
Collapse
Affiliation(s)
- Gregory Morgan
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Selina Casalino
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Sunakshi Chowdhary
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Erika Frangione
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Chun Yiu Jordan Fung
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Elisa Lapadula
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Saranya Arnoldo
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada; William Osler Health System, Brampton, ON L6R 3J7, Canada
| | - Erin Bearss
- Mount Sinai Academic Family Health Team, Mount Sinai Hospital, Toronto, ON M5T 3L9, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
| | - Alexandra Binnie
- Department of Critical Care, William Osler Health System, Etobicoke, ON M9V 1R8, Canada
| | - Bjug Borgundvaag
- Schwartz/Reisman Emergency Medicine Institute, Sinai Health System, Toronto, ON M5G 2A2, Canada
| | | | - Marc Dagher
- Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada; Women's College Hospital, Toronto, ON M5S 1B2, Canada
| | - Luke Devine
- Division of General Internal Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada; Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Steven M Friedman
- Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada; Emergency Medicine, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Zeeshan Khan
- Mackenzie Health, Richmond Hill, ON L4C 4Z3, Canada
| | - Chloe Mighton
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON M5B 1A6, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
| | | | | | - Seth Stern
- Mackenzie Health, Richmond Hill, ON L4C 4Z3, Canada
| | - Ahmed Taher
- Mackenzie Health, Richmond Hill, ON L4C 4Z3, Canada; Division of Emergency Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada
| | - Dawit Wolday
- Department of Biochemistry & Biomedical Sciences, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Jordan Lerner-Ellis
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Jennifer Taher
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada.
| |
Collapse
|
3
|
Morgan G, Casalino S, Chowdhary S, Frangione E, Fung CYJ, Haller S, Lapadula E, Scott M, Wolday D, Young J, Arnoldo S, Aujla N, Bearss E, Binnie A, Bombard Y, Borgundvaag B, Briollais L, Dagher M, Devine L, Faghfoury H, Friedman SM, Gingras AC, Goneau LW, Khan Z, Mazzulli T, McLeod SL, Nomigolzar R, Noor A, Pugh TJ, Richardson D, Satnam Singh HK, Simpson J, Stern S, Strug L, Taher A, Lerner-Ellis J, Taher J. Characterizing Risk Factors for Hospitalization and Clinical Characteristics in a Cohort of COVID-19 Patients Enrolled in the GENCOV Study. Viruses 2023; 15:1764. [PMID: 37632107 PMCID: PMC10457914 DOI: 10.3390/v15081764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/02/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
The GENCOV study aims to identify patient factors which affect COVID-19 severity and outcomes. Here, we aimed to evaluate patient characteristics, acute symptoms and their persistence, and associations with hospitalization. Participants were recruited at hospital sites across the Greater Toronto Area in Ontario, Canada. Patient-reported demographics, medical history, and COVID-19 symptoms and complications were collected through an intake survey. Regression analyses were performed to identify associations with outcomes including hospitalization and COVID-19 symptoms. In total, 966 responses were obtained from 1106 eligible participants (87% response rate) between November 2020 and May 2022. Increasing continuous age (aOR: 1.05 [95%CI: 1.01-1.08]) and BMI (aOR: 1.17 [95%CI: 1.10-1.24]), non-White/European ethnicity (aOR: 2.72 [95%CI: 1.22-6.05]), hypertension (aOR: 2.78 [95%CI: 1.22-6.34]), and infection by viral variants (aOR: 5.43 [95%CI: 1.45-20.34]) were identified as risk factors for hospitalization. Several symptoms including shortness of breath and fever were found to be more common among inpatients and tended to persist for longer durations following acute illness. Sex, age, ethnicity, BMI, vaccination status, viral strain, and underlying health conditions were associated with developing and having persistent symptoms. By improving our understanding of risk factors for severe COVID-19, our findings may guide COVID-19 patient management strategies by enabling more efficient clinical decision making.
Collapse
Affiliation(s)
- Gregory Morgan
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Selina Casalino
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Sunakshi Chowdhary
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Erika Frangione
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Chun Yiu Jordan Fung
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Simona Haller
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Elisa Lapadula
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Mackenzie Scott
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Dawit Wolday
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Juliet Young
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Saranya Arnoldo
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
- William Osler Health System, Brampton, ON L6R 3J7, Canada
| | - Navneet Aujla
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Erin Bearss
- Mount Sinai Academic Family Health Team, Mount Sinai Hospital, Toronto, ON M5T 3L9, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
| | - Alexandra Binnie
- Department of Critical Care, William Osler Health System, Etobicoke, ON M9V 1R8, Canada
| | - Yvonne Bombard
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5B 1A6, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
| | - Bjug Borgundvaag
- Schwartz/Reisman Emergency Medicine Institute, Sinai Health System, Toronto, ON M5G 2A2, Canada
| | | | - Marc Dagher
- Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
- Women’s College Hospital, Toronto, ON M5S 1B2, Canada
| | - Luke Devine
- Division of General Internal Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Hanna Faghfoury
- Fred A Litwin Family Centre in Genetic Medicine, University Health Network & Mount Sinai Hospital, Toronto, ON M5T 3H7, Canada
| | - Steven M. Friedman
- Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
- Emergency Medicine, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Lee W. Goneau
- Dynacare Medical Laboratories, Brampton, ON L6T 5V1, Canada
| | - Zeeshan Khan
- Mackenzie Health, Richmond Hill, ON L4C 4Z3, Canada
| | - Tony Mazzulli
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Microbiology, Mount Sinai Hospital, Sinai Health, Toronto, ON M5G 1X5, Canada
| | - Shelley L. McLeod
- Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
- Schwartz/Reisman Emergency Medicine Institute, Sinai Health System, Toronto, ON M5G 2A2, Canada
| | | | - Abdul Noor
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Trevor J. Pugh
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada
- Ontario Institute for Cancer Research, Toronto, ON M5G 0A3, Canada
| | | | - Harpreet Kaur Satnam Singh
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Jared Simpson
- Ontario Institute for Cancer Research, Toronto, ON M5G 0A3, Canada
- Department of Computer Science, University of Toronto, Toronto, ON M5S 2E4, Canada
| | - Seth Stern
- Mackenzie Health, Richmond Hill, ON L4C 4Z3, Canada
| | - Lisa Strug
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Department of Statistical Sciences, University of Toronto, Toronto, ON M5G 1Z5, Canada
| | - Ahmed Taher
- Mackenzie Health, Richmond Hill, ON L4C 4Z3, Canada
- Division of Emergency Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada
| | - Jordan Lerner-Ellis
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON M5G 1X5, Canada
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Jennifer Taher
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| |
Collapse
|
4
|
Morgan G, Briollais L, Clausen M, Casalino S, Mighton C, Chowdhary S, Frangione E, Yiu Jordan Fung C, Arnoldo S, Bearss E, Binnie A, Borgundvaag B, Dagher M, Devine L, Friedman SM, Khan Z, McGeer A, McLeod SL, Richardson D, Stern S, Taher A, Wong I, Zarei N, Bombard Y, Lerner-Ellis J, Taher J. Public knowledge of SARS-CoV-2 serological and viral lineage laboratory testing and result interpretation: A GENCOV study cross-sectional survey. Clin Biochem 2023:110607. [PMID: 37406717 DOI: 10.1016/j.clinbiochem.2023.110607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 06/27/2023] [Accepted: 07/01/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVES Concepts related to SARS-CoV-2 laboratory testing and result interpretation can be challenging to understand. A cross-sectional survey of COVID-19 positive adults residing in Ontario, Canada was conducted to explore how well people understand SARS-CoV-2 laboratory tests and their associated results. DESIGN AND METHODS Participants were recruited through fliers or by prospective recruitment of outpatients and hospitalized inpatients with COVID-19. Enrolled participants included consenting adults with a positive SARS-CoV-2 polymerase chain reaction test result. An 11-item questionnaire was developed by researchers, nurses, and physicians in the study team and was administered online between April 2021 to May 2022 upon enrolment into the study. RESULTS Responses were obtained from 940 of 1106 eligible participants (85% participation rate). Most respondents understood 1) that antibody results should not influence adherence to social distancing measures (n=602/888, 68%), 2) asymptomatic SARS-CoV-2 infection following test positivity (n=698/888, 79%), 3) serological test sensitivity in relation to post-infection timeline (n=540/891, 61%), and 4) limitations of experts' knowledge related to SARS-CoV-2 serology (n=693/887, 78%). Conversely, respondents demonstrated challenges understanding 1) conflicting molecular and serological test results and their relationship with immune protection (n=162/893, 18%) and 2) the impact of SARS-CoV-2 variants on vaccine effectiveness (n=235/891, 26%). Analysis of responses stratified by sociodemographic variables identified that respondents who were either: 1) female, 2) more educated, 3) aged 18-44, 4) from a high-income household, or 5) healthcare workers responded expectedly more often. CONCLUSIONS We have highlighted concepts related to SARS-CoV-2 laboratory tests and associated results which may be challenging to understand. The findings of this study enable us to identify 1) misconceptions related to various SARS-CoV-2 test results, 2) groups of individuals at risk, and 3) strategies to improve people's understanding of their test results.
Collapse
Affiliation(s)
- Gregory Morgan
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | | | - Marc Clausen
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Selina Casalino
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Chloe Mighton
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Sunakshi Chowdhary
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Erika Frangione
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Chun Yiu Jordan Fung
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Saranya Arnoldo
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada; William Osler Health System, Brampton, ON, Canada
| | - Erin Bearss
- Mount Sinai Academic Family Health Team, Mount Sinai Hospital, Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Bjug Borgundvaag
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Department of Emergency Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Marc Dagher
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Women's College Hospital, Toronto, ON, Canada
| | - Luke Devine
- Division of General Internal Medicine, Mount Sinai Hospital, Toronto, ON, Canada; Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Steven M Friedman
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Emergency Medicine, University Health Network, Toronto, ON, Canada
| | | | - Allison McGeer
- Department of Microbiology, Mount Sinai Hospital, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Shelley L McLeod
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Schwartz/Reisman Emergency Medicine Institute, Sinai Health System, Toronto, ON, Canada
| | | | - Seth Stern
- Mackenzie Health, Richmond Hill, ON, Canada
| | - Ahmed Taher
- Mackenzie Health, Richmond Hill, ON, Canada; Division of Emergency Medicine, University of Toronto, Toronto, ON, Canada
| | - Iris Wong
- Mackenzie Health, Richmond Hill, ON, Canada
| | | | - Yvonne Bombard
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Jordan Lerner-Ellis
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Jennifer Taher
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
| |
Collapse
|
5
|
Casalino S, Mighton C, Clausen M, Frangione E, Chowdhary S, Chung M, Jordan Fung CY, Morgan G, MacDonald G, Lapadula E, Faghfoury H, Arnoldo S, Bearss E, Binnie A, Borgundvaag B, Chertkow H, Devine L, Friedmen SM, Gingras AC, Khan Z, Mazzulli T, McGeer A, McLeod S, Pugh T, Richardson D, Simpson J, Stern S, Strug L, Taher A, Wong I, Zarei N, Kaushik D, Goneau L, Dagher M, Noor A, Greenfeld E, Bombard Y, Taher J, Lerner-Ellis J. eP294: Return of genome sequencing results in ostensibly healthy COVID-19 positive individuals: GENCOV Study Canada. Genet Med 2022. [PMCID: PMC8935071 DOI: 10.1016/j.gim.2022.01.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
6
|
Frangione E, Chung M, Mighton C, Casalino S, Chowdhary S, Satnam Singh HK, Xu L, Di Iorio D, Jain A, Kidwai A, Wong Q, Aujla N, Li JM, Quraishi M, Morgan G, Clausen M, Jordan Fung CY, MacDonald G, Lapadula E, Arnoldo S, Bearss E, Binnie A, Borgundvaag B, Chertkow H, Devine L, Friedmen SM, Gingras AC, Khan Z, Mazzulli T, McGeer A, McLeod S, Pugh T, Richardson D, Simpson J, Stern S, Strug L, Taher A, Wong I, Zarei N, Kaushik D, Goneau L, Dagher M, Greenfeld E, Faghfoury H, Bombard Y, Noor A, Taher J, Lerner-Ellis J. eP325: Medically actionable DNA variation from the GENCOV COVID-19 Genome Sequencing Study. Genet Med 2022. [PMCID: PMC8935062 DOI: 10.1016/j.gim.2022.01.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
7
|
Dagher M, Abdulrahim S, Witt C. Engaging men and boys in gender equity programs in humanitarian settings: A scoping review. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Engaging men and boys in interventions designed to achieve gender equity has demonstrated positive impact on reducing gender-based violence (GBV) and improving women's and girls' health. This scoping review describes the content of published gender equity programs that engage men/boys in humanitarian settings.
Methods
We searched five databases for peer-reviewed articles of GBV programs implemented with men/boys in humanitarian settings (published between Jan 2000 and Dec 2019). From each article, we extracted information on program evaluation strategies, theoretical frameworks, and modes of adaptation to the humanitarian setting.
Results
Of 21 published articles of GBV programs with men/boys (implemented in 17 countries), the majority utilized a psychosocial (attitudes) or structural (feminism) theory and only seven were not theoretically based. As to evaluation, nine programs employed quantitative methods whilst the rest employed qualitative or mixed methods; outcome evaluation data were gathered from both men only or men and women. In most articles, authors described how they developed the program taking into account the humanitarian setting and incorporated practical delivery components to overcome contextual barriers.
Conclusions
In describing the content of published GBV interventions that include men/boys in humanitarian settings, this scoping review can guide future efforts to improve women's/girls' health. Such programs can help realize SDG5 to “achieve gender equality and empower all women and girls.”
Key messages
Including men in interventions designed to improve women’s/girls’ health in humanitarian settings is critical. A scoping review of the published literature can identify existing knowledge and guide future programs.
Collapse
Affiliation(s)
- M Dagher
- Department of Health Promotion and Community Health, American University of Beirut, Beirut, Lebanon
| | - S Abdulrahim
- Department of Health Promotion and Community Health, American University of Beirut, Beirut, Lebanon
| | - C Witt
- Department of Health Promotion and Community Health, American University of Beirut, Beirut, Lebanon
| |
Collapse
|
8
|
Nohra J, Kassir AR, Akel H, Dagher M. Treatment of dentigerous cysts with a modified Hawley plate in children: report of two cases with radiographic results. Br J Oral Maxillofac Surg 2019; 58:102-104. [PMID: 31601436 DOI: 10.1016/j.bjoms.2019.09.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 09/20/2019] [Indexed: 11/25/2022]
Abstract
Dentigerous cysts in young adults may compromise the natural evolution of the dentition and can be treated surgically or non-surgically. We report the minimally-invasive treatment of dentigerous cysts in two young patients using a modified Hawley plate to avoid traumatic injury to anatomical structures, with up to four years' follow up.
Collapse
Affiliation(s)
- J Nohra
- Periodontology Department, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Lebanon.
| | - A R Kassir
- Periodontology Department, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Lebanon
| | - H Akel
- Department of Esthetic and Prosthodontics, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Lebanon
| | - M Dagher
- Periodontology Department, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Lebanon
| |
Collapse
|
9
|
Wong C, Malang S, Sawan M, Smolentsev S, Majumdar S, Merrill B, Sze DK, Morley N, Sharafat S, Dagher M, Peterson P, Zhao H, Zinkle SJ, Abdou M, Youssef M. Assessment of First Wall and Blanket Options with the Use of Liquid Breeder. Fusion Science and Technology 2017. [DOI: 10.13182/fst05-a734] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- C.P.C. Wong
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608
| | - S. Malang
- Fusion Nuclear Technology Consulting, Linkenheim, Germany
| | - M Sawan
- University of Wisconsin, Madison, Wisconsin
| | | | - S. Majumdar
- Argonne National Laboratory, Argonne, Illinois
| | | | - D. K. Sze
- University of California, San Diego, California
| | - N. Morley
- University of California, Los Angeles, California
| | - S Sharafat
- University of California, Los Angeles, California
| | - M. Dagher
- University of California, Los Angeles, California
| | - P. Peterson
- University of California, Berkeley, California
| | - H Zhao
- University of California, Berkeley, California
| | - S. J. Zinkle
- Oak Ridge National Laboratory, Oak Ridge, Tennessee
| | - M. Abdou
- University of California, Los Angeles, California
| | - M Youssef
- University of California, Los Angeles, California
| |
Collapse
|
10
|
Olanrewaju AO, Robillard A, Dagher M, Juncker D. Autonomous microfluidic capillaric circuits replicated from 3D-printed molds. Lab Chip 2016; 16:3804-3814. [PMID: 27722504 PMCID: PMC5314688 DOI: 10.1039/c6lc00764c] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 08/11/2016] [Indexed: 05/17/2023]
Abstract
We recently developed capillaric circuits (CCs) - advanced capillary microfluidic devices assembled from capillary fluidic elements in a modular manner similar to the design of electric circuits (Safavieh & Juncker, Lab Chip, 2013, 13, 4180-4189). CCs choreograph liquid delivery operations according to pre-programmed capillary pressure differences with minimal user intervention. CCs were thought to require high-precision micron-scale features manufactured by conventional photolithography, which is slow and expensive. Here we present CCs manufactured rapidly and inexpensively using 3D-printed molds. Molds for CCs were fabricated with a benchtop 3D-printer, poly(dimethylsiloxane) replicas were made, and fluidic functionality was verified with aqueous solutions. We established design rules for CCs by a combination of modelling and experimentation. The functionality and reliability of trigger valves - an essential fluidic element that stops one liquid until flow is triggered by a second liquid - was tested for different geometries and different solutions. Trigger valves with geometries up to 80-fold larger than cleanroom-fabricated ones were found to function reliably. We designed retention burst valves that encode sequential liquid delivery using capillary pressure differences encoded by systematically varied heights and widths. Using an electrical circuit analogue of the CC, we established design rules to ensure strictly sequential liquid delivery. CCs autonomously delivered eight liquids in a pre-determined sequence in <7 min. Taken together, our results demonstrate that 3D-printing lowers the bar for other researchers to access capillary microfluidic valves and CCs for autonomous liquid delivery with applications in diagnostics, research and education.
Collapse
Affiliation(s)
- A O Olanrewaju
- Biomedical Engineering Department, McGill University, 740 Dr Penfield Avenue, Montreal, QC H3A 0G1, Canada. and McGill University and Genome Quebec Innovation Centre, 740 Dr Penfield Avenue, Montreal, QC H3A 0G1, Canada
| | - A Robillard
- Biomedical Engineering Department, McGill University, 740 Dr Penfield Avenue, Montreal, QC H3A 0G1, Canada. and McGill University and Genome Quebec Innovation Centre, 740 Dr Penfield Avenue, Montreal, QC H3A 0G1, Canada
| | - M Dagher
- Biomedical Engineering Department, McGill University, 740 Dr Penfield Avenue, Montreal, QC H3A 0G1, Canada. and McGill University and Genome Quebec Innovation Centre, 740 Dr Penfield Avenue, Montreal, QC H3A 0G1, Canada
| | - D Juncker
- Biomedical Engineering Department, McGill University, 740 Dr Penfield Avenue, Montreal, QC H3A 0G1, Canada. and McGill University and Genome Quebec Innovation Centre, 740 Dr Penfield Avenue, Montreal, QC H3A 0G1, Canada and Department of Neurology and Neurosurgery, 740 Dr Penfield Avenue, Montreal, QC H3A 0G1, Canada
| |
Collapse
|
11
|
Dagher M, Ng VL, Carpenter A, Rankin S, De Angelis M, Avitzur Y, Mouzaki M. Overweight, central obesity, and cardiometabolic risk factors in pediatric liver transplantation. Pediatr Transplant 2015; 19:175-81. [PMID: 25581506 DOI: 10.1111/petr.12425] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2014] [Indexed: 12/25/2022]
Abstract
UNLABELLED PTMS describes the presence of ≥3 cardiometabolic risk factors that include obesity, hypertension, dyslipidemia, and IR. The prevalence of the clustering of ≥3 cardiometabolic risk factors or central obesity has not been studied in pediatric LT recipients. Single-center, cross-sectional study. INCLUSION CRITERIA LT recipients 2-18 yr-old, at least one yr post-LT. EXCLUSION CRITERIA recipients of liver retransplants or multivisceral transplants. Eighty-seven patients were identified. Median age was 9.8 yr (range 2-18), median time since LT was 6.9 yr (range 1-17). The most common indication for LT was biliary atresia (56%), and the most frequently used immunosuppressant was tacrolimus (80%). The prevalence of overweight and obesity was 21% and 5%, respectively. Central obesity affected 14%, hypertension 44%, IR 27%, low HDL 20%, and hypertriglyceridemia 39% of patients. The prevalence of ≥3 cardiometabolic risk factors was 19%. Fifty percent of the overweight/obese patients had ≥3 risk factors. Time since transplant, immunosuppression and renal function were not different between those with <3 or ≥3 risk factors. Clustering of cardiometabolic risk factors is prevalent in pediatric LT recipients, suggesting an increased risk of future CV events.
Collapse
|
12
|
Wong C, Abdou M, Dagher M, Katoh Y, Kurtz R, Malang S, Marriott E, Merrill B, Messadek K, Morley N, Sawan M, Sharafat S, Smolentsev S, Sze D, Willms S, Ying A, Youssef M. An overview of the US DCLL ITER-TBM program. Fusion Engineering and Design 2010. [DOI: 10.1016/j.fusengdes.2010.02.021] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
13
|
Wong C, Malang S, Sawan M, Dagher M, Smolentsev S, Merrill B, Youssef M, Reyes S, Sze D, Morley N, Sharafat S, Calderoni P, Sviatoslavsky G, Kurtz R, Fogarty P, Zinkle S, Abdou M. An overview of dual coolant Pb–17Li breeder first wall and blanket concept development for the US ITER-TBM design. Fusion Engineering and Design 2006. [DOI: 10.1016/j.fusengdes.2005.05.012] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
14
|
Abstract
Handling patient complaints is possibly one of the most delicate tasks any manager must face. Although managing patient complaints is never a pleasant experience, a detailed plan can make it easier and more uniform, resulting in less stress and anxiety. Before improvements can be accomplished, deficiencies in the system must be corrected. Only after the department's processes have been deemned stable can the qualiuty of care be improved and the customer satisfied.
Collapse
|
15
|
Dagher M, Kobeissi H, Kobressi M, D'Incan J, Effantin C. Generalized morse analytic function for the ?true? diatomic potential of the RKR type. J Comput Chem 1993. [DOI: 10.1002/jcc.540141108] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
16
|
Abstract
An emergency medical service (EMS) system is part of a broad health care system which no longer can be concerned exclusively with patient transportation. Integration of prehospital and in-hospital emergency care must be achieved to provide quality patient care. This article suggests modifications in the Joint Commission on Accreditation of Healthcare Organization's (JCAHO) 10-Step Model indicators that should help in an evaluation of the issues associated with the diversion of patients from Emergency Departments. The JCAHO model is one that can be used to help integrate prehospital and inhospital care.
Collapse
Affiliation(s)
- M Dagher
- Emergency Services, Memorial Medical Center of Jacksonville, Florida
| | | |
Collapse
|
17
|
|
18
|
Dagher M. An emergency department perspective--Part III, Outcomes. Physician Exec 1991; 17:46-9. [PMID: 10112417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
The outcome of care has traditionally been defined as a "change in the patient's current and future health status that can be attributed to antecedent health care." However, this definition provides a "unidimensional view of quality." It fails to take into account the customer's attributes and the many small steps or process variances that can contribute to an unexpected outcome. This failure can be especially pronounced in the emergency department.
Collapse
Affiliation(s)
- M Dagher
- Memorial Medical Center, Jacksonville, FL
| |
Collapse
|
19
|
Dagher M. An emergency department perspective: Part II. Process review. Physician Exec 1991; 17:26-30. [PMID: 10110135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Webster defines process as a "series of actions or operations conducting to an end." Each of the many processes that may be involved with providing a service or procedure comprises many smaller steps. It is the monitoring of those steps that we call a process review. The process review for quality management begins when a patient perceives the need to receive emergency care. It embodies the technical and interpersonal aspects of the patients, and the staff's interpersonal relationships.
Collapse
Affiliation(s)
- M Dagher
- Memorial Medical Center, Jacksonville, FL
| |
Collapse
|
20
|
Abstract
Negative outcome management depends upon reducing variances in the structure and process of health care. In the multitask environment of a hospital's emergency department (ED), a system is required to monitor the many tasks for variances. Without a monitoring system in place, the cumulative effect of these structure and process variances will significantly contribute to negative outcomes. Structure and process variance management requires a customer-focused, process-conceptualization approach that attempts to manage the many small variances in care along the entire chain of interdependent processes making up the ED system. Process mapping is one technique that enables management to understand and anticipate variances and take corrective action to eliminate them before they occur.
Collapse
Affiliation(s)
- M Dagher
- Emergency Services, Memorial Center, Jacksonville, FL
| | | |
Collapse
|
21
|
Dagher M. An emergency department perspective--Part one. Physician Exec 1990; 16:14-6. [PMID: 10113508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
High patient volumes requiring rapid turn around times, critical decision making processes, and a necessity for establishing an accurate working diagnosis are a few of the many challenges in hospital emergency departments. Quality management, rather than quality assurance, most accurately describes how activities in the emergency department should be monitored to meet these challenges. Already an important factor in manufacturing and service industries across the United States, quality management will become the essential driving force in the health care industry. To survive in the '90s, the emergency department must include in its goals the development of plans and processes that meet the challenge of the ED environment and that focus on customer satisfaction.
Collapse
Affiliation(s)
- M Dagher
- Memorial Medical Center, Jacksonville, FL
| |
Collapse
|
22
|
Kobeissi H, Dagher M, El-Hajj A, Kobeissi M. On the computation of matrix elements between numerical wave functions: The canonical functions method. J Comput Chem 1989. [DOI: 10.1002/jcc.540100309] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
23
|
Abstract
We have presented a case of mesenteroaxial volvulus in a 12-year-old girl. Since this entity is rare in children, one must be especially alert to its possibility for early diagnosis and treatment of this potential catastrophe.
Collapse
|